Provider Demographics
NPI:1952017386
Name:ADIPARAMBATH, NAVEENA
Entity Type:Individual
Prefix:
First Name:NAVEENA
Middle Name:
Last Name:ADIPARAMBATH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1617
Mailing Address - Country:US
Mailing Address - Phone:908-307-5373
Mailing Address - Fax:
Practice Address - Street 1:23 N WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1617
Practice Address - Country:US
Practice Address - Phone:908-307-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12079200163W00000X
NJ26NJ01428800363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse